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Peer review Peer review information Nature Communications thanks Mitsuyasu Hasebe, Hiroaki Mano, Andrej Pavlovic and Michael Wudick for their contribution to the peer review of this work

Texas MD License #J2933), provides medical oversight that aligns internal medicine with chiropractic, functional medicine, personal injury care, rehabilitation, allergy testing and immunotherapy, pelvic floor therapies, and systems-based protocols

It is important to note that B12 levels should ideally be measured before commencing replacement therapy, as supplementation rapidly normalises biochemical markers, potentially obscuring the diagnosis

Sixthly, trace lineage studies indicate that both NCs and CLCs are derived from the embryonic notochord, suggesting that NCs are precursors of CLCs [78, 79]